Systems, devices, and methods for mechanically reducing and fixing bone fractures

Abstract

Bone fracture reduction devices, systems, and methods couple to a patient platform a mechanical bone fracture reduction fixture, which is sized and configured to be conveyed separate from the patient platform. The bone fracture reduction fixture carries an array of mechanical force reduction assemblies that are sized and configured to independently mechanically manipulate a fractured bone region. Each mechanical force reduction assembly functions independently of the other mechanical force reduction assemblies, to independently apply and maintain one of the prescribed mechanical reduction forces to the fracture and also mechanically reduce the fracture in the desired reduction planes.

We claim: 
     
       1. A bone fracture reduction system comprising:
 a patient platform that is sized and configured to support an individual having a bone fracture; 
 a mechanical bone fracture reduction fixture that is sized and configured to be conveyed separate from the patient platform, the mechanical bone fracture reduction fixture including a mount to join the fixture to the patient platform to support the bone fracture for reduction by the mechanical bone fracture reduction fixture and, after a reduction of the fracture is achieved, to separate the fixture from the patient platform; 
 a mechanical guidance mechanism sharing a common frame with the mechanical bone fracture reduction fixture, the mechanical guidance mechanism being sized and con inured to guide placement of one or more bone fixing devices to fix the reduction of the fracture; 
 a guide bushing that is sized and configured to be joined to the mechanical guidance mechanism to form a path for the one or more bone fixing devices; and 
 packaging that maintains the guide bushing in a sterile condition prior to being joined to the mechanical guidance mechanism, 
 wherein the mount joins the common frame to the patient platform for fracture reduction by the mechanical bone fracture reduction fixture and fixing by the mechanical guidance mechanism and, after fracture reduction and fixing are achieved, to separate the common frame from the patient platform. 
 
     
     
       2. A system according to  claim 1 
 and further including an orthotic brace that is sized and configured to be fitted to a region of the bone fracture before, during, or after the reduction of the fracture by the mechanical bone fracture reduction fixture. 
 
     
     
       3. A system according to  claim 1 
 wherein the patient platform is selected from a family of patient platforms comprising an operating table, a gurney, a bed, a chair, and a fracture reduction table. 
 
     
     
       4. A system according to  claim 1 
 wherein the patient platform includes a side rail, and 
 wherein the mount joins the bone fracture reduction fixture to the side rail. 
 
     
     
       5. A system according to  claim 1 
 wherein the mount joins the bone fracture reduction fixture in a cantilevered orientation to a side of the patient platform. 
 
     
     
       6. A mechanical boric fracture reduction system comprising
 a frame that is sized and configured to support a bone fracture, 
 a first reduction mechanism on the frame that is sized and configured to apply to the bone fracture a first mechanical force vector that moves the bone fracture into a first anatomic orientation, including a mechanism that is sized and configured to mechanically interact with the first fracture reduction mechanism to maintain a desired alignment in the first anatomic orientation, 
 a second reduction mechanism on the frame that is sized and configured to apply to the bone fracture, independent of the application of the first mechanical force vector, a second mechanical force vector that moves the bone fracture into alignment in a second anatomic orientation different than the first anatomic orientation, including a mechanism that is sized and configured to mechanically interact with the second reduction mechanism to maintain a desired alignment in the second anatomic orientation, and 
 a mount on the frame to join the frame to a patient support platform for reduction of the bone fracture by the mechanical bone fracture reduction fixture and, after a reduction of the fracture is achieved, to separate the frame from the patient platform. 
 
     
     
       7. A system according to  claim 6 
 further including a mechanical guidance mechanism on the frame that is sized and configured to guide placement of one or more bone fixing devices to maintain desired alignments in the first and second anatomic orientations. 
 
     
     
       8. A system according to  claim 6 
 further including an orthotic brace that is sized and configured to be assembled in the region of the bone fracture, and 
 wherein the frame includes a carrier for the orthotic brace either partially or fully assembled in a region of the bone fracture. 
 
     
     
       9. A system according to  claim 6 
 further including an orthotic brace that is sized and configured to be assembled in a region of the bone fracture, and 
 wherein the frame includes a carrier for releasable attachment of the orthotic brace either partially or fully assembled in the region of the bone fracture. 
 
     
     
       10. A system according to  claim 6 
 and further including at least one additional reduction mechanism on the frame that is sized and configured to apply to the bone fracture, independent of both the first and second mechanical force vectors, at least one additional mechanical force vector that moves the bone fracture into alignment in at least one additional anatomic orientation, different than the first and second anatomic orientations, including a mechanism that is sized and configured to mechanically interact with the at least one additional reduction mechanism to maintain a desired alignment in the at least one additional anatomic orientation. 
 
     
     
       11. A fracture reduction system for a supracondylar fracture in an arm bone region of a patient comprising a humerus and a forearm separated by an elbow, the system comprising
 a frame that is sized and configured to support the arm bone region for reduction with the humerus extended at a right angle from the patient along a reduction perpendicular axis, the forearm articulated upward relative to the elbow along a reduction vertical axis, and the native articulation axis of the elbow oriented along a reduction horizontal axis that extends generally parallel to the body axis of the patient, 
 a distal traction mechanical force reduction assembly on the frame that is sized and configured to apply to the supracondylar fracture a first mechanical force vector along the reduction perpendicular axis to separate a distal region of the fracture from a proximal region of the fracture, achieving, at least in part, distal traction of the supracondylar fracture, including a mechanism that is sized and configured to mechanically interact with the distal traction mechanical force reduction assembly to maintain a desired orientation in a first anatomic orientation, 
 a second mechanical force reduction assembly on the frame that is sized and configured to apply to the supracondylar fracture, independent of the first mechanical force vector, a second mechanical force reduction vector along the reduction vertical axis or reduction horizontal axis or both reduction vertical and horizontal axes to move the distal region of the fracture and/or the proximal region of the fracture, achieving, at least in part, one of superior traction, lateral translation, varus/valgus rotation, pronation/supination rotation, and flexion/extension rotation of the supracondylar fraction, the second mechanical force reduction assembly including a mechanism that is sized and configured to mechanically interact with the second mechanical force reduction assembly to maintain a desired orientation alignment in a second anatomic orientation without altering the first anatomic orientation, and 
 a mount on the frame to join the frame to a patient support platform for reduction of the bone fracture by the mechanical bone fracture reduction fixture and, after a reduction of the fracture is achieved, to separate the frame from the patient platform. 
 
     
     
       12. A system according to  claim 11 
 further including a mechanical guidance mechanism on the frame that is sized and configured to guide placement of one or more bone fixing devices to maintain desired alignments in the first and second anatomic orientations. 
 
     
     
       13. A system according to  claim 11 
 further including an orthotic brace that is sized and configured to be fitted to the proximal region and/or distal region of the fracture, and 
 wherein the frame includes a carrier for the orthotic brace either partially or fully fitted to the proximal region and/or distal region of the fracture. 
 
     
     
       14. A system according to  claim 11 
 further including an orthotic brace that is sized and configured to be fitted to the proximal region and/or distal region of the fracture, and 
 wherein the frame includes a carrier for releasable attachment of the orthotic brace either partially or fully fitted to the proximal region and/or distal region of the fracture. 
 
     
     
       15. A system according to  claim 11 
 and further including at least one additional reduction mechanism on the frame that is sized and configured to apply to the supracondylar fracture, independent of both the first and second mechanical force vectors, at least one additional mechanical force vector along the reduction vertical axis or reduction horizontal axis or reduction perpendicular axis or combinations thereof to move the distal region of the fracture and/or the proximal region of the fracture, achieving, at least in part, another one of superior traction, lateral translation, varus/valgus rotation, pronation/supination rotation, and flexion/extension rotation of the supracondylar fraction, the third mechanical force reduction assembly including a mechanism that is sired and configured to mechanically interact with the third mechanical force reduction assembly to maintain a desired orientation alignment in a third anatomic orientation without altering either the first or second anatomic orientations. 
 
     
     
       16. A system according to  claim 15 
 further including a mechanical guidance mechanism on the frame that is sized and configured to guide placement of one or more bone fixing devices to maintain desired alignments in the first, second, and third anatomic orientations. 
 
     
     
       17. A method for reducing a bone fracture comprising the steps of:
 locating a patient platform that is sized and configured to support an individual having as bone fracture; 
 providing a mechanical bone fracture reduction fixture that is sized and configured to be carried to patient platform, the mechanical bone fracture reduction fixture including a mount to join the fixture to the patient platform to support the bone fracture; 
 joining the fixture to the patient platform to support the bone fracture; 
 operating the mechanical bone fracture reduction fixture to apply mechanical force vectors to mechanically reduce the bone fracture; 
 after a reduction of the fracture is achieved, separating the fixture from the patient platform; 
 before, during or after the reduction, attaching the orthotic brace to a carrier on the mechanical bone fracture reduction fixture in either a partially or fully assembled condition to a region of the one fracture; and 
 after reduction and assembly of the orthotic brace to the region of the bone fracture, releasing the orthotic brace from the carrier, wherein the orthotic brace can be worn by the individual to maintain and/or improve the reduction, after fixing, while healing occurs. 
 
     
     
       18. A method according to  claim 17 ,
 further including a step of fitting an orthotic brace to a region of the bone fracture before, during, or after the reduction. 
 
     
     
       19. A method according to  claim 17 
 further including placing one or more bone fixing de vices to fix the reduction of the fracture. 
 
     
     
       20. A method according to  claim 17 
 wherein the bone fracture involves an arm including the humerus and/or forearm and/or wrist; or involves a leg including the tibia and/or fibula; or involves articulating condyles including at, in, or near the elbow, or at, in, or near the knee. 
 
     
     
       21. A method according to  claim 17  wherein the bone fracture comprises a supracondylar fracture. 
     
     
       22. A method according to  claim 17 
 wherein the patient platform is selected from a family of patient platforms comprising an operating table, a gurney, a bed, a chair, and a fracture reduction table.